Central New York Care Collaborative, Inc. PPS Community Profile

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1 Central New York Care Collaborative, Inc. PPS Community Profile Counties served: Cayuga, Lewis, Madison, Oneida, Onondaga, and Oswego DEMOGRAPHICS 1 The total population of the Central New York Care Collaborative (CNY Care Collaborative) PPS s six counties is 1,002,825. The region s largest city is Syracuse (population 144,669) in Onondaga County. Age: Across all six counties, 21.4% of the population is age 60 or older. Race/Ethnicity: Overall, the six counties have a population that is 84.2% White. Only Onondaga County has a non-white population that comprises more than 20% of the total population. Foreign-born residents: Only 5.7% of residents are foreign-born. Language: 91.3% of residents of these counties speak only English at home. Between 0.9% and 3.4% of each county s residents speak Spanish at home, and those that do generally identify as of Puerto Rican, Mexican, or Dominican descent. Poverty: Oswego County has the greatest percentage (18.5%) of residents living below Federal Poverty Guidelines (FPG), while Madison County (9.5%) has the lowest. Central New York Care Collaborative PPS Executive Summary page 1

2 HIV/AIDS 2 3 New HIV Diagnoses: Between 2011 and 2013, there were a total of 199 new HIV diagnoses in the PPS s six counties. Onondaga County had the largest number of new cases 142 during these three years. Lewis County had the lowest only one new HIV case. HIV incidence rates for these counties, with the exception of Onondaga County s 10.1 incidence, are lower than NY State s case rate with New York City excluded 8.2 new cases per 100,000 residents. PLWHA: As of December 31, 2013, there were 1,498 people living with HIV/AIDS in the PPS s region; each county s number of PLWHA ranged from 6 (Lewis County) to 978 (Onondaga County). The HIV prevalence rates for these counties are lower than New York State s prevalence rate with New York City excluded per 100,000 residents. Deaths: Between 2011 and 2013, a total 73 deaths occurred among PLWHA in the PPS region. HIV/AIDS Hospitalization Costs: In 2014, HIV-related hospitalization costs across the counties (96 patients and 1,227 days) totaled $6.3 million; 77% of costs occurred in Onondaga County. Central New York Care Collaborative PPS Executive Summary page 2

3 HIV DISPARITIES 1 2 HIV and AIDS disproportionately impact non-white residents and especially residents identifying as Hispanic (of any race), Black (non-hispanic), and Multi-Race (non-hispanic) across all six of the PPS s counties. Despite Black individuals making up only 6.9% of the counties total population, this racial group represented 30.2% of all PLWHA in the region, as well as 35.2% of the region s new HIV diagnoses between 2011 and Similarly, Hispanics accounted for 12.6% of new diagnoses and 10.9% of PLWHA in these six counties, while comprising only 3.8% of the total population. Overall, the majority of PLWHA in this region are White (49.5%). Of all PLWHA in the PPS region, 15.5% (232 individuals) indicated transmission by injection drug use (IDU) or MSM/IDU, and 42.8% (641) indicated transmission by MSM. Central New York Care Collaborative PPS Executive Summary page 3

4 HIV RISK FACTORS Homelessness The CNY Care Collaborative PPS spans four HUD Continuum of Care (CoC) regions (CoC NY-502, NY-505, NY-518, and NY-522), which are comprised of Cayuga, Onondaga, Oswego, Oneida, Madison, Jefferson, Lewis, and St. Lawrence Counties. o In this region in January 2015, a total of 1,148 individuals were homeless. Of these, 1,111 were sheltered and 37 were unsheltered. o Twenty-nine percent 332 individuals were members of homeless families. o The number of homeless unaccompanied youth (under age 25) was 147. Parolees in the Region As of December 2015, 4,810 parolees reside in the Central New York region. Counties included in the Central New York region: Cayuga, Chenango, Clinton, Columbia, Cortland, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Onondaga, Oswego, Otsego, Rensselaer, Saratoga, Seneca, St. Lawrence, Warren, and Washington. Substance Use Over 23% of adults in the PPS region smoke cigarettes, a rate higher than the statewide rate of 15.9%. Cayuga County has the highest rate of smokers (34.3% of adults). 18.1% of adults reported binge drinking in the last month, ranging from 10.6% of adults in Lewis County to 25.0% in Oswego County. The statewide rate is 17.7%. The six counties in the CNY Care Collaborative PPS incurred total drug and alcoholrelated hospitalization costs of over $34.9 million in 2014, serving 2,486 patients. o Onondaga County incurred the vast majority of drug and alcohol-related hospitalization costs, treating 1,928 patients at a cost of over $27.1 million. o Oneida County had the second largest proportion at 359 patients and $5.2 million in costs, followed by Cayuga at 108 patients and $1.3 million in costs. PPS-wide, the majority of costs ($14.9 million) were incurred by the 1,150 patients admitted for Alcohol Abuse and Dependence. o Next, 478 patients were admitted for Drug or Alcohol Dependence with Rehab Stay, which incurred over $10.7 million in costs. o Opioid Abuse and Dependence was the cause of admission for 288 patients and the source of $3.3 million in hospitalization costs. Central New York Care Collaborative PPS Executive Summary page 4

5 Mental Health Average Age-adjusted Percentage of Adults with Poor Mental Health for 14 days or more Days in the Past Month: 14.5%, higher than the state-wide rate of 11.1%. In Madison County, only 7.2% of adults indicated poor mental health, while Cayuga had the highest rate of poor mental health at 19.5%. Mental health-related hospitalization costs across all six counties totaled over $112.7 million, serving 6,324 patients in o The vast majority of mental health-related hospitalization costs were incurred by Onondaga County ($66.9 million), which served 2,500 mental health patients. o Oneida County served 2,512 patients at cost of $29.8 million; Oswego served 837 patients for $9.1 million; and, Cayuga served 462 patients for $6.5 million. o Lewis and Madison counties each served fewer than 10 patients and incurred less than $250,000 in costs. PPS-wide, the majority of mental health-related hospitalization costs were for 3,542 patients admitted for mood disorders, incurring a cost of $57.0 million. Schizophrenia and other psychotic disorders accounted for $40.8 million and 1,745 patients, and 1,037 patients were admitted for other mental health disorders, incurring $14.9 million. Central New York Care Collaborative PPS Executive Summary page 5

6 SOURCES 1 U.S. Census Bureau, American Community Survey 5-Year Estimates. 2 New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August (SPARCS). APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). 4 U.S. Housing and Urban Development, Continuum of Care Homeless Assistance Program Homeless Population and Subpopulation Report, Point in Time (PIT) counts from January Published November Retrieved July 2016 from 5 New York State Department of Corrections, 2015 FOIA request on Community Supervision Offenders NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of Retrieved July 2016 from (SPARCS). APR Major Diagnostic Category (MDC) by Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR MDC = Alcohol / Drug Use & Alcohol/Drug Induced Organic Mental Disorders. APR DRG = Alcohol & Drug Dependence w Rehab or Rehab/Detox Therapy (772); Alcohol Abuse & Dependence (775); Cocaine Abuse & Dependence (774); Drug & Alcohol Abuse or Dependence, Left Against Medical Advice (770); Opioid Abuse & Dependence (773); and Other Drug Abuse & Dependence (776). 8 (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. APR MDC = Mental Diseases and Disorders. CCS Diagnosis Categories = Mood Disorders (657); Schizophrenia and other psychotic disorders (659); and, sum of all other CCS Diagnoses under Mental Diseases and Disorders: Adjustment Disorders (650), Anxiety Disorders (651), Attention-Deficit (652), Delirium (653), Developmental Disorders (654), Miscellaneous Disorders (670), Other congenital abnormalities (217), Personality disorders (658), and Suicide and other intentional self-inflicted injury (662) NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of Retrieved July 2016 from Central New York Care Collaborative PPS Executive Summary page 6

7 Community-Based Organizations funded by NYS Department of Health, AIDS Institute in the CNY Care Collaborative PPS Region AIDS Community Resources, Inc. (ACR Health) 627 West Genesee St Syracuse, NY Contact person: Michael Crinnin, Executive Director Phone: (315) Center for Community Alternatives 115 East Jefferson St Suite 300 Syracuse, NY Contact person: Marsha Weissman, Executive Director Phone: (315) Syracuse Model Neighborhood Facility, Inc. 401 South Ave Syracuse, NY Contact person: Sharon F. Owens, CEO Phone: (315) Central New York Care Collaborative PPS Executive Summary page 7

8 Additional Resources AIDS Institute HIV Education & Training Program The site offers a range of trainings that are intended for non-physician health and human services providers who offer HIV, STI and viral hepatitis prevention, testing, care, and support services. All trainings are free of charge and funded by the New York State Department of Health AIDS Institute. Ending the Epidemic (ETE) Dashboard This purpose of this site is to measure, track and disseminate actionable information on progress towards achieving New York State s Ending the Epidemic (EtE) Initiative s goals to all interested stakeholders. NYS Department of Health HIV/AIDS Home Page The New York State Department of Health, AIDS Institute has lead responsibility for coordinating state programs, services and activities relating to HIV/AIDS, sexually transmitted diseases (STDs) and hepatitis C. The site provides resources related to the AIDS Institute s priorities and work as well as links to resources for consumers and providers and surveillance statistics. NY Links NY Links focuses on improving linkage to care and retention in care and supports the delivery of routine, timely, and effective care for Persons living with HIV/AIDS (PLWHA) in New York State. NY Links uses a regional approach, utilizing the learning collaborative model, to fortify the links holding together communities of practice, and the links grounding them in the communities of consumers they serve. Central New York Care Collaborative PPS Executive Summary page 8

9 DEMOGRAPHICS i Cayuga County Community Profile Cayuga County s Total Population is 79,481. Residents in Cayuga County are older; they have a median age of 42.3, and 22.9% are 60 years or older. Over 91% of the population is White; 3.9% is Black, 2.6% Hispanic, 1.6% Multi-Race and 0.9% Other Races. Only 2.3% of residents are foreign-born. 95% of residents speak only English at home; the majority of the 2.3% who speak Spanish at home identify as from Puerto Rico. ECONOMIC INDICATORS ii Indicator Cayuga County NY Statewide Rate Median Household Income $51,792 $58,687 % living at less than 100% of Federal Poverty Level 12.4% 16.0% Unemployment Rate 8.3% 8.9% % receiving Medicaid / means-tested Public Coverage 18.3% 22.5% % Uninsured 9.5% 10.6% HIV/AIDS IN CAYUGA COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Cayuga County was 3.7 per year. Annual HIV incidence is 4.6 per 100,000 residents. PLWHA: As of December 31, 2013, there were 93 people living with HIV/AIDS in Cayuga County. HIV prevalence is 117 per 100,000 residents. (New York State s overall prevalence is per 100,000 residents.) Deaths: Between 2011 and 2013, the average annual number of deaths among PLWHA was 2.0. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA Cayuga County page 1 % # Deaths among PLWHA Total % % % Sex at Birth Male % % % Female % % % Age 12 & under % 0 0.0% % % 1 1.1% % % 6 6.5% % % 2 2.2% % % 9 9.7% % % % % % % % % % % %

10 HIV/AIDS Hospitalization Costs iv In 2014, medical centers in Cayuga County reported $0 in hospitalization costs and 0 patients admitted for HIV with Major and Multiple Major Related Conditions. HIV/AIDS Disparities HIV and AIDS disproportionately impact non-white individuals in Cayuga County, especially those who identify as Black (not Hispanic), Multi-Race (not Hispanic), and Hispanic (of any race). From 2011 through 2013, of the eight new HIV diagnoses among males, 100% had a transmission risk of men who have sex with men (MSM). Among the three females newly diagnosed during those three years, 100% had transmission risks of either heterosexual contact or presumed heterosexual contact. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total % % MSM % % IDU % 4 5.9% MSM/IDU % % Heterosexual % 4 5.9% Blood Products % 0 0.0% Pediatric Risk % 1 1.5% Unknown % % Transmission Risk Group Females Total % % IDU % % Heterosexual Contact % % Cayuga County page 2

11 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Female Presumed Heterosexual Contact % % Blood Products % 0 0.0% Pediatric Risk % 0 0.0% Unknown % 0 0.0% HIV/AIDS RISK FACTORS Homelessness In January 2015, 101 people in Cayuga County were homeless, according to the Point in Time count for the Cayuga County Continuum of Care (CoC) region (CoC NY-502). vi o Of these, 98 homeless people were sheltered and 3 were unsheltered. o Fifty-one percent - 52 individuals - were members of homeless families. o The number of homeless unaccompanied youth (under age 25) was 13. Substance Use Among adults, 34.3% of adults smoke cigarettes, more than double than the New York Statewide rate of 15.9% of adults. The percentage of adults in Cayuga County who report binge drinking in the past month is 14.0%, lower than the statewide rate of 17.7%. vii In 2014, Drug/Alcohol-Related Hospitalizations in Cayuga County had a total cost of over $1.3 million, for 108 patients staying for 600 total days. viii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 19.5% - higher than the statewide rate of 11.1%. ix Hospitalizations due to mood disorders and schizophrenia or other psychotic disorders accounted for 435 patients, 3,244 hospital days, and over $6.1 million in costs in Another $398,254 was incurred by 27 patients with other mental health disorders. x Cayuga County page 3

12 Cayuga County page 4

13 REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August iv (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August vi U.S. Housing and Urban Development, Continuum of Care Homeless Assistance Program Homeless Population and Subpopulation Report, Point in Time (PIT) counts from January Published November Retrieved August 8, 2016 from vii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of viii (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. ix NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of x (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Cayuga County page 5

14 DEMOGRAPHICS i Lewis County Community Profile Lewis County s Total Population is 27,164. Residents of Lewis County have a median age of 41.1, and 21.9% are 60 years or older. 96.2% of the population is White; 1.0% is Black, 1.6% Hispanic, 0.6% Multi-Race and 0.6% Other Races. Only 1.8% of residents are foreign-born. 97% of residents speak only English at home; less than 1% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Lewis County NY Statewide Rate Median Household Income $46,990 $58,687 % living at less than 100% of Federal Poverty Level 13.3% 16.0% Unemployment Rate 9.2% 8.9% % receiving Medicaid / means-tested Public Coverage 20.3% 22.5% % Uninsured 10.6% 10.6% HIV/AIDS IN LEWIS COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Lewis County was 0.3 per year. Annual HIV incidence is 1.2 per 100,000 residents. PLWHA: As of December 31, 2013, there were 6 people living with HIV/AIDS in Lewis County. HIV prevalence rate is 22.1 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: Between 2011 and 2013, no deaths occurred among PLWHA. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA % # Deaths among PLWHA Total % % % Sex at Birth Male % % % Female % % % Age 12 & under % 0 0.0% % % 0 0.0% % % % % % 0 0.0% % % 0 0.0% % % % % % % % % % % % Lewis County page 1

15 HIV/AIDS Hospitalization Costs iv In 2014, Lewis County reported $0 in hospitalization costs and 0 patients admitted for HIV with Major and Multiple Major Related Conditions. HIV/AIDS Disparities In Lewis County, HIV and AIDS disproportionately impacts Black (not Hispanic) individuals. Almost 17% of PLWHA in the county identify as Black, despite Black residents representing only 1.6% of the total County population. However, the largest proportion of PLWHA in the County are White. From 2011 through 2013, zero men were newly diagnosed with HIV. Of all current male PLWHA, 75% indicated a transmission of men who have sex with men (MSM). The one female newly diagnosed during these three years had a transmission risk of presumed heterosexual contact. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total % % MSM % % IDU % 0 0.0% MSM/IDU % 0 0.0% Heterosexual % % Blood Products % 0 0.0% Pediatric Risk % 0 0.0% Unknown % 0 0.0% Transmission Risk Group Females Total % % IDU % 0 0.0% Heterosexual Contact % % Female Presumed Heterosexual Contact % % Lewis County page 2

16 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Blood Products % 0 0.0% Pediatric Risk % 0 0.0% Unknown % 0 0.0% HIV/AIDS RISK FACTORS Substance Use Among adults, 16.4% of adults smoke cigarettes, higher than the New York State-wide rate of 15.9% of adults. The percentage of adults in Lewis County who report binge drinking in the past month is 10.6%, lower than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Lewis County had a total cost of $97,030 for 9 patients admitted for 37 total days, the majority admitted for Alcohol Abuse and Dependency. vii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 8.3% - less than the statewide rate of 11.1%. viii Hospitalizations due to mood disorders and schizophrenia or other psychotic disorders accounted for only 2 patients, 5 hospital days, and $15,673 in costs in One additional patient was admitted for an other mental health disorder for 3 days, with cost of $11,347. ix Lewis County page 3

17 Lewis County page 4

18 REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August iv (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Lewis County page 5

19 DEMOGRAPHICS i Madison County Community Profile Madison County s Total Population is 72,731. Residents of Madison County have a median age of 40.1, and 21.6% are 60 years or older. 93.7% of the population is White; 1.8% is Black, 1.9% Hispanic, 1.2% Multi-Race and 1.4% Other Races. Only 2.1% of residents are foreign-born. 96% of residents speak only English at home; 1.1% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Madison County NY Statewide Rate Median Household Income $53,584 $58,687 % living at less than 100% of Federal Poverty Level 11.2% 16.0% Unemployment Rate 5.3% 8.9% % receiving Medicaid / means-tested Public Coverage 16.4% 22.5% % Uninsured 6.5% 10.6% HIV/AIDS IN MADISON COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Madison County was 2.0 per year. Annual HIV incidence is 2.8 per 100,000 residents. PLWHA: As of December 31, 2013, there were 41 people living with HIV/AIDS in Madison County. HIV prevalence rate is 56.6 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: Between 2011 and 2013, the average annual number of deaths among PLWHA was 1.0. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA % # Deaths among PLWHA Total % % % Sex at Birth Male % % % Female % % % Age 12 & under % 0 0.0% % % 0 0.0% % % 0 0.0% % % 4 9.8% % % % % % % % % % % % 4 9.8% % % Madison County page 1

20 HIV/AIDS Hospitalization Costs iv In 2014, Madison County reported $0 in hospitalization costs and 0 patients admitted for HIV with Major and Multiple Major Related Conditions. HIV/AIDS Disparities In Madison County, HIV and AIDS disproportionately impacts non-white individuals, including those identifying as Black (not Hispanic), Multi-Race (not Hispanic), Other Race (not Hispanic), and Hispanic (of any race). Over 29% of PLWHA in the county are non-white, despite non-white residents representing only 6.3% of the total County population. However, the largest proportion of PLWHA in the County are White (70.7%). From 2011 through 2013, of the five males newly diagnosed with HIV, 100% indicated transmission risk of men who have sex with men (MSM). Of all current male PLWHA, 58.3% indicated a transmission of men who have sex with men (MSM). The one females newly diagnosed during these three years as well as 82% of all female PLWHA - had a transmission risk of heterosexual or presumed heterosexual contact. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total % % MSM % % IDU % 1 2.0% MSM/IDU % 2 6.7% Heterosexual % 0 0.0% Blood Products % 1 3.3% Pediatric Risk % 0 0.0% Unknown % % Transmission Risk Group Females Total % % Madison County page 2

21 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) IDU % % Heterosexual Contact % % Female Presumed Heterosexual Contact % % Blood Products % 0 0.0% Pediatric Risk % 0 0.0% Unknown % 0 0.0% HIV/AIDS RISK FACTORS Substance Use Among adults, 17.1% of adults smoke cigarettes, higher than the New York State-wide rate of 15.9% of adults. The percentage of adults in Madison County who report binge drinking in the past month is 16.0%, lower than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Madison County had a total cost of $541,314 for 35 patients admitted for 130 total days, the majority admitted for Alcohol Abuse and Dependency. vii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 7.2% - lower than the statewide rate of 11.1%. viii Two patients admitted for schizophrenia or other psychotic disorders accounted for 23 hospital days and $70,866 in costs in Eight patients were admitted for an other mental health disorder for a total 53 days, with cost of $141,020. ix Madison County page 3

22 Madison County page 4

23 REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August iv (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Madison County page 5

24 DEMOGRAPHICS i Oneida County Community Profile Oneida County s Total Population is 233,944. Residents of Oneida County have a median age of 41.2, and 23.6% are 60 years or older. 83.8% of the population is White; 5.6% is Black, 5.0% Hispanic, 1.9% Multi-Race and 3.7% Other Races. 7.4% of residents are foreign-born. 88% of residents speak only English at home; of the 3.4% who speak Spanish at home, the majority identify as from Puerto Rico or the Dominican Republic. ECONOMIC INDICATORS ii Indicator Oneida County NY Statewide Rate Median Household Income $48,931 $58,687 % living at less than 100% of Federal Poverty Level 16.5% 16.0% Unemployment Rate 8.0% 8.9% % receiving Medicaid / means-tested Public Coverage 24.6% 22.5% % Uninsured 6.9% 10.6% HIV/AIDS IN ONEIDA COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Oneida County was 9.7 per year. Annual HIV incidence is 4.1 per 100,000 residents. PLWHA: As of December 31, 2013, there were 284 people living with HIV/AIDS in Oneida County. HIV prevalence rate is per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: Between 2011 and 2013, the average annual number of deaths among PLWHA was 4.3. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA % # Deaths among PLWHA Total % % % Sex at Birth Male % % % Female % % % Age 12 and under % % % % % % % 7 2.5% % % % % % % % % % % % % % % % % % Oneida County page 1

25 HIV/AIDS Hospitalization Costs iv In 2014, a total of $1,403,719 in costs were incurred by 24 patients admitted for HIV with Major and Multiple Major Related Conditions. Nine patients were treated for HIV with Major Related Conditions, accounting for $270,129 in hospitalization costs. 15 patients were treated for HIV with Multiple Major Related Conditions, at a total cost of $1,133,590. HIV/AIDS Disparities In Oneida County, HIV and AIDS disproportionately impacts non-white individuals, especially those identifying as Black (not Hispanic), Multi-Race (not Hispanic), and Hispanic (of any race). Over 51% of PLWHA in the county are non-white, despite non-white residents representing only 16.2% of the total County population. From 2011 through 2013, 56% of males newly diagnosed with HIV indicated a transmission risk of men who have sex with men (MSM); the remainder indicated unknown transmission risk. Of females newly diagnosed during these three years, 91% as well as 83% of all female PLWHA - had a transmission risk of heterosexual or presumed heterosexual contact. HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total % % MSM % % IDU % % MSM/IDU % % Heterosexual % 9 5.1% Blood Products % % Pediatric Risk % 3 1.7% Unknown % % Oneida County page 2

26 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Females Total % % IDU % % Heterosexual Contact % % Female Presumed Heterosexual Contact % % Blood Products % 0 0.0% Pediatric Risk % 3 2.8% Unknown % 0 0.0% HIV/AIDS RISK FACTORS Substance Use Among adults, 23.7% of adults smoke cigarettes, higher than the New York State-wide rate of 15.9% of adults. The percentage of adults in Oneida County who report binge drinking in the past month is 16.0%, similar to the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Oneida County had a total cost of over $5.2 million for 359 patients admitted for 1,436 total days. The largest proportion of hospitalization costs was $3.9 million for 249 patients admitted for Alcohol Abuse and Dependency. vii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 14.2% - higher than the statewide rate of 11.1%. viii Hospitalizations due to mood disorders and schizophrenia or other psychotic disorders accounted for 2,125 patients, 15,211 hospital days, and over $25.0 million in costs in In addition, 387 patients were admitted for an other mental health disorder, for a total 2,678 days and cost of $4.7 million. ix Oneida County page 3

27 Oneida County page 4

28 REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August iv (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Oneida County page 5

29 DEMOGRAPHICS i Onondaga County Community Profile Onondaga County s Total Population is 467,846. Residents of Onondaga County have a median age of 38.7, and 20.5% are 60 years or older. 78.4% of the population is White; 10.7% is Black, 4.3% Hispanic, 2.4% Multi-Race and 4.2% Other Races. 7.2% of residents are foreign-born. 90% of residents speak only English at home; of the 3.0% who speak Spanish at home, the majority identify as from Puerto Rico, Mexico, or the Dominican Republic. ECONOMIC INDICATORS ii Indicator Onondaga County NY Statewide Rate Median Household Income $54,498 $58,687 % living at less than 100% of Federal Poverty Level 15.3% 16.0% Unemployment Rate 7.8% 8.9% % receiving Medicaid / means-tested Public Coverage 18.8% 22.5% % Uninsured 7.7% 10.6% HIV/AIDS IN ONANDAGO COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Onondaga County was 47.3 per year. Annual HIV incidence is 10.1 per 100,000 residents. PLWHA: As of December 31, 2013, there were 978 people living with HIV/AIDS in Onondaga County. HIV prevalence rate is per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: Between 2011 and 2013, the average annual number of deaths among PLWHA was HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA % # Deaths among PLWHA Total % % % Sex at Birth Male % % % Female % % % Age 12 and under % 3 0.3% % % 6 0.6% % % % % % % % % % % % % % % % % % % % % Onandago County page 1

30 HIV/AIDS Hospitalization Costs iv In 2014, a total of $4,859,979 in costs were incurred by 70 patients admitted for HIV with Major and Multiple Major Related Conditions. 36 patients were treated for HIV with Major Related Conditions, accounting for $1,560,737 in hospitalization costs. 34 patients were treated for HIV with Multiple Major Related Conditions, at a total cost of $3,299,242. HIV/AIDS Disparities In Onondaga County, HIV and AIDS disproportionately impacts non-white individuals, especially those identifying as Black (not Hispanic), Multi-Race (not Hispanic), and Hispanic (of any race). Over 55.8% of PLWHA in the county are non-white, despite non-white residents representing only 21.6% of the total county population. From 2011 through 2013, 70% of males newly diagnosed with HIV indicated a transmission risk of men who have sex with men (MSM); 19% indicated unknown transmission risk. Of females newly diagnosed during these three years, 90.4% as well as 79.7% of all female PLWHA - had a transmission risk of heterosexual or presumed heterosexual contact. Twelve percent of all PLWHA (121 individuals) indicate transmission by injection drug use (IDU). HIV/AIDS Incidence and Prevalence by Transmission Risk v HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total % % MSM % % IDU % % MSM/IDU % % Heterosexual % % Blood Products % 5 0.8% Pediatric Risk % % Onandago County page 2

31 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Unknown % % Transmission Risk Group Females Total % % IDU % % Heterosexual Contact % % Female Presumed Heterosexual Contact % % Blood Products % 0 0.0% Pediatric Risk % 8 2.4% Unknown % 2 0.6% HIV/AIDS RISK FACTORS Substance Use Among adults, 21.3% of adults smoke cigarettes, higher than the New York State-wide rate of 15.9% of adults. The percentage of adults in Onondaga County who report binge drinking in the past month is 18.8%, similar to the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Onondaga County had a total cost of over $27.1 million for 1,928 patients admitted for 17,641 total days. The largest proportion of hospitalization costs was $10.8 million for 478 patients admitted for Drug/Alcohol Dependency with Rehab Stay, with an average length of stay of 24 days. vii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 15.6% - higher than the statewide rate of 11.1%. viii Hospitalizations due to mood disorders and schizophrenia or other psychotic disorders accounted for 2,068 patients, 21,083 hospital days, and over $58.5 million in costs in In addition, 432 patients were admitted for an other mental health disorder, for a total 2,655 days and cost of $8.37 million. ix Onandago County page 3

32 Onandago County page 4

33 REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August iv (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Onandago County page 5

34 DEMOGRAPHICS i Oswego County Community Profile Oswego County s Total Population is 121,659. Residents of Oswego County have a median age of 38.9, and 19.4% are 60 years or older. 94.7% of the population is White; 0.8% is Black, 2.2% Hispanic, 1.4% Multi-Race and 0.9% Other Races. Only 1.9% of residents are foreign-born. 96% of residents speak only English at home; 1.7% speak Spanish at home. ECONOMIC INDICATORS ii Indicator Oswego County NY Statewide Rate Median Household Income $47,646 $58,687 % living at less than 100% of Federal Poverty Level 18.5% 16.0% Unemployment Rate 10.3% 8.9% % receiving Medicaid / means-tested Public Coverage 24.2% 22.5% % Uninsured 8.5% 10.6% HIV/AIDS IN OSWEGO COUNTY New HIV Infections: Between 2011 and 2013, the average annual number of new HIV diagnoses in Oswego County was 3.3 per year. Annual HIV incidence is 2.8 per 100,000 residents. (New York State s overall incidence rate is 19.1 per 100,000 residents.) PLWHA: As of December 31, 2013, there were 96 people living with HIV/AIDS in Oswego County. HIV prevalence rate is 79.2 per 100,000 residents. (New York State s overall prevalence rate is per 100,000 residents.) Deaths: Between 2011 and 2013, the average annual number of deaths among PLWHA was 1.0. HIV/AIDS Incidence, Prevalence, and Deaths iii # of New HIV Diagnoses % # of PLWHA % # Deaths among PLWHA Total % % % Sex at Birth Male % % % Female % % % Age 12 and under % 0 0.0% % % 0 0.0% % % 4 4.2% % % 7 7.3% % % % % % % % % % % % % % % Oswego County page 1

35 HIV/AIDS Hospitalization Costs iv In 2014, a total of $48,537 in costs were incurred by two patients admitted for HIV with Multiple Major Related Conditions. HIV/AIDS Disparities In Oswego County, HIV and AIDS disproportionately impacts non-white individuals, especially those identifying as Black (not Hispanic), Multi-Race (not Hispanic), and Hispanic (of any race). Almost 20% of PLWHA in the county are non-white, despite non-white residents representing only 5.3% of the total County population. However, 80% of PLWHA in the County are White. Of the eight males newly diagnosed with HIV from 2011 through 2013, 75% indicated a transmission risk of men who have sex with men (MSM); 25% indicated unknown transmission risk. Of the two females newly diagnosed during these three years, one indicated a transmission risk of heterosexual contact and one indicated transmission by injection drug use (IDU). 9.4% percent of all PLWHA (9 individuals) in the County indicated transmission by injection drug use (IDU) or MSM/IDU. HIV/AIDS Incidence and Prevalence by Transmission Risk v Oswego County page 2 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Transmission Risk Group Males Total % % MSM % % IDU % 4 4.9% MSM/IDU % 4 4.9% Heterosexual % 4 4.9% Blood Products % 0 0.0% Pediatric Risk % 0 0.0% Unknown % % Transmission Risk Group Females Total % % IDU % 1 6.7%

36 HIV Diagnoses ( Annual Average) Living HIV and AIDS Cases (December 2013) Heterosexual Contact % % Female Presumed Heterosexual Contact % % Blood Products % 0 0.0% Pediatric Risk % 0 0.0% Unknown % 0 0.0% HIV/AIDS RISK FACTORS Substance Use Among adults, 26.3% of adults smoke cigarettes, significantly higher than the New York State-wide rate of 15.9% of adults. The percentage of adults in Oswego County who report binge drinking in the past month is 25.0%, higher than the statewide rate of 17.7%. vi In 2014, Drug/Alcohol-Related hospitalizations in Oswego County had a total cost of $554,720 for 47 patients admitted for 181 total days. The largest proportion of hospitalization costs was $413,815 for 30 patients admitted for Alcohol Abuse and Dependency for a total of 144 hospital days. vii Mental Health In 2014, the age-adjusted percentage of adults who reported poor mental health for 14 or more days in the past month is 13.4% - higher than the statewide rate of 11.1%. viii Hospitalizations due to mood disorders and schizophrenia or other psychotic disorders accounted for 655 patients, 5,902 hospital days, and almost $8.0 million in costs in In addition, 182 patients were admitted for an other mental health disorder, for a total 854 days and cost of $1,232,885. ix Oswego County page 3

37 Oswego County page 4

38 REFERENCES i U.S. Census Bureau, American Community Survey 5-Year Estimates. ii U.S. Census Bureau, American Community Survey 5-Year Estimates. iii New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August iv (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group (DRG) Report by County for 2014 Inpatient Data. APR DRG = HIV with Major Related Conditions (892) and HIV with Multiple Major Related Conditions (890). v New York State HIV/AIDS County Surveillance Report (Excludes State Prison Inmates) For Cases Diagnosed Through December Bureau of HIV/AIDS Epidemiology AIDS, AIDS Institute, New York State Department of Health, August vi NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of vii (SPARCS). APR Major Diagnostic Category (MDC) by APR Diagnosis Related Group Report by County for 2014 Inpatient Data. viii NYS Expanded Behavioral Risk Factor Surveillance System (NYS Counties outside NYC); 2013 NYS Behavioral Risk Factor Surveillance System (NYC counties), data as of ix (SPARCS). APR Major Diagnostic Category (MDC) by Clinical Classification (CCS) Diagnosis Category Report by County for 2014 Inpatient Data. Oswego County page 5

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